# CLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progression

Source: https://onco.cc/pairings/cldn18-antibody-then-adc/  
OnCo record `cldn18-antibody-then-adc` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hit Claudin 18.2 twice: first with a plain antibody plus chemotherapy, then with an ADC or engineered cells when the cancer comes back.

## Summary

Zolbetuximab + chemotherapy is approved first line; CLARITY-Gastric 01 showed an OS benefit for the CLDN18.2 ADC sonesitatug vedotin in later lines (July 2026); satri-cel CAR-T is approved in China. Whether prior zolbetuximab reduces ADC benefit (antigen persistence, ADCC-selected clones) is the key unknown.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Zolbetuximab + Sonesitatug vedotin
- Type: sequence
- Rationale: CLDN18.2 is a lineage antigen that tends to persist; the three modalities kill by different mechanisms (ADCC/CDC, payload, T cells).
- Evidence: Phase 3 for each agent individually; sequencing data pending.

## Sources

- ClinicalTrials.gov NCT03504397: SPOTLIGHT & GLOW: https://clinicaltrials.gov/study/NCT03504397
- ClinicalTrials.gov NCT06346392: CLARITY-Gastric 01: https://clinicaltrials.gov/study/NCT06346392

## Connected records

- cancers: [Claudin 18.2-positive gastric cancer](https://onco.cc/cancers/gastric-cldn18-2-positive/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/)
- targets: [Claudin 18.2](https://onco.cc/targets/cldn18-2/)
- drugs: [Satricabtagene autoleucel](https://onco.cc/drugs/satricabtagene-autoleucel/), [Sonesitatug vedotin](https://onco.cc/drugs/cmg901/), [Zolbetuximab](https://onco.cc/drugs/zolbetuximab/)
- trials: [CLARITY-Gastric 01](https://onco.cc/trials/clarity-gastric01/), [SPOTLIGHT & GLOW](https://onco.cc/trials/spotlight-glow/)

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